This proposal is for years 20 through 23 of the Seattle Longitudinal Prospective Study on Alcohol and Pregnancy. The overall objective of the research is to determine the long-term consequences of maternal alcohol use during pregnancy on the health and development of the offspring. The present proposal would permit the first examination of young adults whose prenatal alcohol exposure had been determined by maternal self-report in mid-pregnancy 21 years ago. The basic hypothesis for this long-term study of the teratogenic effects of alcohol in humans is that prenatal alcohol exposure exerts an enduring dose-dependent effect on adult neurobehavioral function. Five Specific Aims will be addressed: 1. Four domains of cognitive function will be examined in 21-year-old offspring, in relation to prenatal alcohol exposure as mediated by earlier manifestations of cognitive dysfunction and modified by appropriate covariates. The four domains include: Attention/Concentration, Executive Function, Memory, and Information Processing. 2. Adaptive and emotional functioning in 21-year old offspring will be examined in relation to prenatal alcohol exposure as mediated by earlier measures of behavioral dysfunction and modified by appropriate covariates. 3. Contextual/environmental factors assessed throughout the lifespan from mid-pregnancy through 21 years will be examined in relation to offspring function at 21 years. 4. Morphologic and physical size dimensions in 21-year old offspring will be examined in relation to prenatal alcohol exposure, as modified by appropriate covariates. 5. The full spectrum of fetal alcohol effects, measured in this study through the first 21 years of life, will be examined to identify those earlier patterns of alcohol-related deficits that could serve as clinical markers for individual children at risk for adverse outcome. These proposed studies have far-reaching public health implications. Alcohol remains the teratogenic drug most frequently ingested during pregnancy. This would be the first opportunity to examine the adult consequences of a wide variety of patterns and levels of alcohol use and abuse using a cohort that has manifested subtle neurobehavioral effects of prenatal alcohol exposure at many earlier ages. Findings from this study have direct implications for public policy, efforts to prevent fetal alcohol effects, and methods for the detection and appropriate remediation of children and adults at risk for adverse effects of prenatal alcohol exposure.